Healthcare Provider Details
I. General information
NPI: 1588902456
Provider Name (Legal Business Name): LANDMARK EXAMS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/28/2013
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5725 W HIGHWAY 290 STE 202
AUSTIN TX
78735-8722
US
IV. Provider business mailing address
5725 W HIGHWAY 290 STE 202
AUSTIN TX
78735-8722
US
V. Phone/Fax
- Phone: 512-494-4219
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 202C00000X |
| Taxonomy | Independent Medical Examiner Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LEON
STEARNS
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 512-970-8490